Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $80.55 / $169.92	Facility	26	$19.50	$80.55	$169.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $53.72 / $76.17	Professional		$29.85	$53.72	$76.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.55 / $28.96	Professional	26	$19.50	$19.55	$28.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.31 / $34.22 / $47.21	Professional	TC	$10.31	$34.22	$47.21
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $58.53 / $101.84	Professional		$52.68	$58.53	$101.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.11 / $23.27 / $29.09	Professional	26	$21.11	$23.27	$29.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $10.02 / $35.26 / $44.07	Professional	TC	$10.02	$35.26	$44.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $82.18 / $224.44	Professional		$40.94	$82.18	$224.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $37.65 / $86.32	Professional	26	$21.63	$37.65	$86.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.21 / $39.18 / $138.12	Professional	TC	$13.21	$39.18	$138.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $58.25 / $124.26	Professional		$48.61	$58.25	$124.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $21.63 / $45.25	Professional	26	$18.96	$21.63	$45.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.65 / $36.61 / $79.03	Professional	TC	$29.65	$36.61	$79.03
United Facility/Professional Professional Modifier Low / Median / High Price $27.03 / $59.88 / $149.49	Professional		$27.03	$59.88	$149.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.28 / $26.20 / $58.51	Professional	26	$17.28	$26.20	$58.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.28 / $33.68 / $95.05	Professional	TC	$10.28	$33.68	$95.05